Many recent advancements in transgender rights have been followed by setbacks. Obama era rules that protected transgender patients from discrimination have been rolled back, and just last week the Trump administration announced plans to define gender for federal civil rights laws as biological, immutable and determined at birth. Now a new article by Julie Furr Youngman and Courtney Hauck warns that a 2010 U.S. Tax Court case that upheld the medical expense deduction for gender affirmation surgery may come back to haunt the transgender community if its dicta is interpreted as requiring proof of medical necessity. (Note: For definitions and terms preferred by the transgender community, please see the National Center for Transgender Equality.)

As the U.S. fertility industry explodes, there is plenty of talk about surrogate miscarriages, freezer failures, unwieldy donor family trees, problems with privacy and anonymity, and the physical and emotional tolls of egg and sperm donation. What’s missing from the conversation? According to Professor Bridget Crawford, the answer is “tax talk.” Crawford’s article, which focuses on how egg donors talk about taxes with each other and their fertility clinics, is an empirically grounded exploration into the ways that talking about tax (or failing to do so) reflects and reinforces cultural norms.

The article begins by recounting the facts of a 2015 tax court case called Perez v. Commissioner. In that case, the taxpayer Nichelle Perez had received fees for her “time, effort, inconvenience, pain, and suffering in donating her eggs.” Perez earned her fees. She underwent a series of painful hormone injections that resulted in pain, bruising and burning. She submitted to general anesthesia and an invasive egg removal procedure that left her cramped, bloated, nauseous, fatigued and moody.